Understanding Fatty Liver Disease

Nathan Hamm, DC, FNP-C.

In 2023 a group of over 200 physicians, public health experts, and industry leaders from around the globe voted to rename non-alcoholic fatty liver disease or NAFLD to metabolic dysfunction-associated steatotic liver disease or MASLD.  The goal was to update outdated nomenclature and better reflect the metabolic nature of the disease.  Experts hope that the rebrand will spark more conversation – and research interest – around these conditions that still lack treatment options.

Non-alcoholic steatohepatitis or NASH was coined in the 1980s and was meant to differentiate from fatty liver that was traditionally caused by excessive alcohol consumption. NAFLD and NASH are used interchangeably and over the past few decades several attempts were made to update the terminology unsuccessfully. But all that changed last year and NASH is now MASH, metabolic dysfunction associated steatohepatitis.

What is MASH?

MASLD or MASH is a form of liver disease caused by metabolic risk factors where excess fat accumulates in the liver and creates inflammation. When not diagnosed or left untreated it can lead to scarring and permanent liver damage. Common risk factors for MASH include: Obesity, type 2 diabetes, insulin resistance, high cholesterol or triglycerides, and high blood pressure.

Although only around 4.5 million adults in the U.S. have been diagnosed with some form of liver disease it’s estimated that up to 25% of the U.S. adult population could have MASH or some other type of liver condition and not even know it.  MASH affects nearly 12% of the global population and is most commonly seen in patients with obesity and type 2 diabetes. Survey data suggests that MASH is an underdiagnosed condition. Hopefully, the recent name change will help to increase public awareness.

In general, symptoms of liver disease are often vague or non-existent. Some symptoms of a fatty liver may include, excess weight around the midsection, right upper abdominal pain discomfort or fullness, gastrointestinal upset including nausea and/or bloating, and fatigue or weakness. Most people don’t have any symptoms and a diagnosis of MASH is often made due to abnormal liver function tests.

Velocity Clinical Research is proud to help develop innovative therapies that are designed to assist in the diagnosis, treatment and prevention of liver disease. Velocity uses FibroScan Technology to help detect and stage fatty liver disease for their patients. Excessive inflammation from MASH can cause fibrosis and scarring of the liver and these changes are measured on a scale of 0-4. The FibroScan is a non-invasive type of elastography that uses ultrasound technology to measure the stiffness(hardness) and fatty changes to the liver to help assist in the diagnosis of MASH.

Regarding treatment, weight loss and healthy lifestyle choices remain the cornerstone for the management of MASH. But earlier this year Madrigal Pharmaceuticals received FDA approval for Rezdiffra (resmetirom) as the first ever therapy for adults with MASH. Jeff McIntyre, vice president of Liver Health Programs at non-profit Global Liver Institute, said in a statement. “This approval gives patients and healthcare providers a long-awaited tool to change the trajectory of their chronic liver disease.”   

Velocity Clinical Research was part of the research that went into that approval. We worked with that study for about 2 years, screened over 65 patients and enrolled almost half of them. Currently we have other liver studies that are enrolling. Many people find joining a clinical trial to be a rewarding experience, especially when you see the therapy you help develop actually come to market. Velocity aims to be a resource in the community for medical decision making.

If you are interested in hearing more about clinical trials or what we have to offer please contact our office at 315-760-5905.

Leave a Comment